Céline Grimaldi1, François Brémont2, Michèle Berlioz-Baudoin3, Jacques Brouard4, Harriet Corvol5, Laure Couderc6, Guillaume Lezmi7, Isabelle Pin8, Isabelle Petit9, Philippe Reix10, Natacha Remus11, Cyril Schweitzer12, Caroline Thumerelle13, Jean-Christophe Dubus14. 1. Service de pneumologie pédiatrique et CRCM, CHU Timone, 264 rue St Pierre, 13005, Marseille, France. celine.grimaldi@ap-hm.fr. 2. Département de pédiatrie, Hôpital des enfants, 31026, Toulouse, France. bremont.f@chu-toulouse.fr. 3. Service de pédiatrie et CRCM pédiatrique, Hôpitaux pédiatriques de Nice CHU-Lenval, 06200, Nice, France. berlioz-baudoin.m@pediatrie-chulenval-nice.fr. 4. Service de pédiatrie, CHU Caen, 14033, Caen, France. brouard-j@chu-caen.fr. 5. Service de pédiatrie et pneumologie, Hôpital d'Enfants Armand-Trousseau, AP-HP, 75571, Paris, France. harriet.corvol@trs.aphp.fr. 6. Département de pédiatrie médicale, CHU Hôpitaux de Rouen, 76031, Rouen, France. laure.couderc@chu-rouen.fr. 7. Service de pneumologie et allergologie pédiatriques, Hôpital Necker Enfants Malades, AP-HP, 75015, Paris, France. guillaume.lezmi@nck.aphp.fr. 8. Département de pédiatrie-Centre mucoviscidose, CHU de Grenoble, Hôpital Albert Michallon, 38043, Grenoble, France. IPin@chu-grenoble.fr. 9. CRCM mixte, CHU Estaing, 63003, Clermont-Ferrand, France. ipetit@chu-clermontferrand.fr. 10. Département de pneumologie pédiatrique, Hôpital Femme Mère Enfant, CHU de Lyon, 69500, Bron, France. philippe.reix@chu-lyon.fr. 11. Département de pédiatrie, Centre Hospitalier Intercommunal de Créteil, 94010, Créteil, France. Natacha.Remus@chicreteil.fr. 12. Service de médecine infantile, Hôpital d'enfants de Nancy, Rue du Morvan, 54511, Vandoeuvre-Les-Nancy, France. c.schweitzer@chu-nancy.fr. 13. Service de pneumologie pédiatrique, Pôle enfant Hôpital Jeanne de Flandre, CHRU de Lille, 59037, Lille, France. caroline.thumerelle@chru-lille.fr. 14. Service de pneumologie pédiatrique et CRCM, CNRS-URMITE 6236, CHU Timone, 264 rue St Pierre, 13005, Marseille, France. jean-christophe.dubus@ap-hm.fr.
Abstract
The influence of the generalization of cystic fibrosis newborn screening (CFNBS) in France on sweat test (ST) prescription is unknown. In this French retrospective, descriptive, and multicenter study, we studied the indications, number, methods, and results of STs prescribed by a pediatric pulmonologist in children who had a negative CFNBS and an ST for respiratory symptoms in 2012. We included 502 children with 523 STs, performed with four different methods. The main indication was asthma (71.3 %), then chronic cough (52.4 %), atypical lower airway infections (42.2 %), and bronchiectasis (7 %). Four children had a diagnosis of CF (0.8 %), all presenting with chronic productive cough and recurrent respiratory infections. CONCLUSION: Asthma is the most frequent indication of ST in our cohort. Because of the systematic CFNBS in France, some prescriptions should be avoided, particularly in case of severe or moderate asthma with no other associated symptom. Moreover, methods of STs often do not follow the guidelines and need standardization. WHAT IS KNOWN: • Newborn screening (NBS) has become the most frequent circumstance of the diagnosis of cystic fibrosis (CF) in France after its generalization. • The prescription of sweat test (ST) in children with respiratory symptoms who already had a negative NBS has not been studied. WHAT IS NEW: • In children with a negative CF NBS referred to a university hospital for respiratory diseases, despite important variations of ST methods, only 4 children among 502 have been diagnosed as CF. • Despite recommendations, ST prescription should be avoided in children with moderate to severe asthma and no other associated symptom.
The influence of the generalization of cystic fibrosis newborn screening (CFNBS) in France on sweat test (ST) prescription is unknown. In this French retrospective, descriptive, and multicenter study, we studied the indications, number, methods, and results of STs prescribed by a pediatric pulmonologist in children who had a negative CFNBS and an ST for respiratory symptoms in 2012. We included 502 children with 523 STs, performed with four different methods. The main indication was asthma (71.3 %), then chronic cough (52.4 %), atypical lower airway infections (42.2 %), and bronchiectasis (7 %). Four children had a diagnosis of CF (0.8 %), all presenting with chronic productive cough and recurrent respiratory infections. CONCLUSION: Asthma is the most frequent indication of ST in our cohort. Because of the systematic CFNBS in France, some prescriptions should be avoided, particularly in case of severe or moderate asthma with no other associated symptom. Moreover, methods of STs often do not follow the guidelines and need standardization. WHAT IS KNOWN: • Newborn screening (NBS) has become the most frequent circumstance of the diagnosis of cystic fibrosis (CF) in France after its generalization. • The prescription of sweat test (ST) in children with respiratory symptoms who already had a negative NBS has not been studied. WHAT IS NEW: • In children with a negative CF NBS referred to a university hospital for respiratory diseases, despite important variations of ST methods, only 4 children among 502 have been diagnosed as CF. • Despite recommendations, ST prescription should be avoided in children with moderate to severe asthma and no other associated symptom.
Entities:
Keywords:
Pediatric pulmonology; Prescription; Respiratory symptoms; Sweat test
Authors: M Rota; T Nguyen-Khoa; M Marchand; D Feldmann; J Dumont; D Khalfon; A Vassault; J-P Borgard Journal: Ann Biol Clin (Paris) Date: 2008 Mar-Apr Impact factor: 0.459
Authors: K C Lødrup Carlsen; G Hedlin; A Bush; G Wennergren; F M de Benedictis; J C De Jongste; E Baraldi; C Pedroletti; A Barbato; K Malmström; P Pohunek; S Pedersen; G L Piacentini; R J M Middelveld; K H Carlsen Journal: Eur Respir J Date: 2010-10-28 Impact factor: 16.671
Authors: Alethéa Guimarães Faria; Fernando Augusto Lima Marson; Carla Cristina Souza Gomez; Maria de Fátima Servidoni; Antônio Fernando Ribeiro; José Dirceu Ribeiro Journal: Front Pediatr Date: 2017-10-26 Impact factor: 3.418